G. KARUNAKARAN MEMORIALC O - O P E R A T I V E C O L L E G E O
FMANAGEMENT & TECHNOLOGY
www.gkmcmt.com Co-operation......Democracy... Education
P.B.No.5, Kakkode, Karakulam.P.O. iruvananthapuram. 695 564.
IndiaPhone : 0472-2 88 63 99 email: [email protected]
PHOTO
APPLICATION NO
Application for Admission to MBA full-time Programme
PERSONAL DATAName of the Candidate
Name & Occupation of Father / Guardian
1
2
3
4
5
6
7
8
9
10
Age & Date of Birth
*Attach copy of caste certi�cate in case of SC/ST candidates
Sex
Nationality
Marital Status
Religion/ Caste*
Annual Income
Relationship with the candidate
Permanent Address
M F
Address for Correspondence
PIN PIN
Phone Phonee-mail Mobile
ACADEMIC QUALIFICATIONS
Matriculation.......................................................................................................................school............................................................
Course
+2 or
Equivalent..................................................................................................................school............................................................
Graduation or
Equivalent.......................................................................................................College............................................................
Period(year)
Name of Examination passed and Board / University
Main/Subjects..............................................................................Board/Uty.................................
Main/ Subjects..........................
...................................................
Board /Uty.................................
Post Graduation or
Equivalent.............................................................................................College...........................................................
Main/
Subjects.................................................................................Board
/Uty...................................
Class/Rank
Result**Total
Marks Marks
Secured %Marks Secured
**For B.A,B.Com and B.Sc degree Examination marks for part are
to be entered separately. For all other degrees aggregate marks can
be entered. Marks obtained till date may be entered in case of
candidates appearing for their �nal examination.
Part I & II Part I & II Part I & II
Part III Part III Part III
Aggregate Aggregate Aggregate
I,..........................................................here
by declare that all the information provided in this application is
true to the best of my knowledge and that I understand that any
misrepresentation by me in this application will disqualify my
candidature.
Place:Date :
Signature:Name :
Place:Date :
Signature:Name :
K-MAT/ CAT/C-MAT DETAILS(Attach true copy of Scorecard)
ROLL NO. K-MAT/CAT/C-MAT SCORE YEAR & MONTH
ADDITIONAL QUALIFICATIONS,IF ANY
HOSTEL ACCOMODATION REQUIRED
ADDITIONAL INFORMATION,IF ANY
DECLARATION BY THE APPLICANT
DECLARATION BY THE GUARDIAN
FOR OFFICE USE
GUARDIAN CONTACT PHONE NO
DETAILS OF DOCUMENTS SUBMITTED
SSLC/CBSE
DEGREE MARKLIST
TC
PLUS TWO CERTIFICATE
CONDUCT CERTIFICATE
K-MAT/CAT/C-MAT SCORE
DEGREE CERTIFICATE
CASTE CERTIFICATE
OTHER CERTIFICATEDownloaded application should be accompanied by
a DD for Rs.500/- in favour of "THE MEMBER SECRETARY, GKMES"
payable at iruvananthapuram. Duly �lled application form along
with copies of certi�cates should be sent to:-G KARUNAKARAN
MEMORIAL CO- OPERATIVE COLLEGE OF MANAGEMENT AND TECHNOLOGY,
PB.NO.5, KAKKODE , KARAKULAM. P.O.,THIRUVANANTHAPURAM-695
564
Yes No
I,..........................................................fully
aware of the above declaration and have understood the same.I agree
to all the above condition.
Admission Details
Date Admission No. Category Fees paid Rs.
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